Summary
Traumatic high ulnar nerve injuries have historically resulted in long-term loss of
hand function due to the long re-innervation distance to the intrinsic muscles. Transfer
of the anterior interosseous nerve (AIN) to the deep motor branch of the ulnar nerve
(MUN) is proving promising in these patients. The purpose of this study was to evaluate
the outcomes and efficacy of this procedure in our series. Eligible high ulnar nerve
injury patients who underwent AIN to MUN nerve transfer were evaluated with a mean
follow-up of 17 months. Data including demographics, injury details, surgical procedures,
and outcomes were collected. A review of the current literature was performed for
comparison. Sixteen patients had AIN to MUN transfer, mean age of 39.4 years, and
a median delay from injury to nerve transfer of 0.8 months. The injury site was above
the elbow in 5 cases, at the elbow in 8 cases, and in the proximal forearm in 3 cases.
The majority were sharp transection, with the remaining from blast injuries, traumatic
traction, and one post-traumatic neuroma resection. Transfer was performed end-to-end
in 7 cases, hemi end-to-end in 7 cases, and supercharged end-to-side in 2 cases. Five
patients achieved intrinsic muscle recovery of MRC 4+ and thirteen gained MRC 3 or
above. The AIN to MUN nerve transfer provides meaningful intrinsic recovery in the
majority of traumatic high ulnar nerve injuries. This procedure should be routinely
considered, however, warrants further research to validate the optimum technique.
Keywords
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Article info
Publication history
Published online: October 22, 2021
Accepted:
September 27,
2021
Received:
January 20,
2021
Identification
Copyright
© 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
